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6Reduction and fixation of the intermediate column

Reduction of the dorsoulnar fragment

The retracted dorsoulnar fragment is then replaced and preliminarily secured with a K-wire that additionally holds in place the reduced central articular fragment.
The radiocarpal joint surface is checked for residual gap, or step off.

Note

If a large metaphyseal defect is created by elevation of the central impacted fragment, and especially if a nonlocking plate is used, autogenous cancellous bone should be packed into the gap, prior to reduction of the dorsoulnar fragment.